Understand how we got here — and how to move forward.


September 20, 2017

You've got to stop losing your millennial staff. Here's how to do it.

Daily Briefing

Editor's note: This story was updated on November 30, 2017.

The health care workforce has a problem.

Demand for health care jobs is on the rise: One-third of new U.S. jobs in the next decade will be in the industry.

But that rising demand has been accompanied by rising turnover. The health care industry had a median 13.8% turnover rate in 2016, up from 9.9% in 2010.

Some turnover is inevitable, but it doesn't have to be this high. Hospitals and health systems can take several steps to retain more employees, Kate Vonderhaar, a practice manager with Advisory Board's HR Advancement Center, tells the Daily Briefing.

But to do so, organizations need to better understand the needs of the key group of workers responsible for 30% of last year's turnover at the typical hospital: employees with less than one year of tenure, many of whom are millennials.

How millennials are—and aren't—different from past generations

There are three reasons millennials are more likely to leave than employees from other generations in the workforce, Vonderhaar says. First, millennials are younger and have less experience in the workforce to help put their current position in context; they're thus more likely to believe—rightly or wrongly—that the grass is greener elsewhere.

Second, they "think about their career on a shorter time frame," Vonderhaar says. "They're thinking about the next six to 12 months, not necessarily the next five to 10 years."

And finally, millennials have a wider range of opportunities in the health care field than their predecessors had. "Not only can they go work for the hospital down the road, but now they can work at a retail clinic," she adds. "And their skills are transferrable. Staff trained on a specific electronic health record can go work for a consulting company and make a lot more money."

All of this means you're competing with more companies for a small pool of talent, so it's crucial to keep millennials engaged.

Advisory Board's Survey Solutions Employee Engagement team has found that, by and large, millennials' engagement drivers are similar to other generations'. Millennials are most engaged when they believe in their organization's mission, enjoy their work, and see opportunities for growth and promotion.

Where employees under age 35 and those with less than three years of tenure differ from other workers, though, is that even when they feel engaged with their work, they are not yet loyal to their employer. By contrast, older employees' engagement levels tend to correlate with their loyalty levels.

But just because they aren't loyal now doesn't mean millennials will never be loyal. Those first three years are crucial, Vonderhaar says. "If you can hold onto them beyond that, their loyalty level will catch up with their engagement level."

Vonderhaar shares three keys to holding onto millennials for those early years.

1. Give millennials an early sense of accomplishment

Millennial workers are thinking about their career on a shorter timeframe, so it's important to help them feel a sense of accomplishment early on in their tenure, Vonderhaar says.

Millennials' managers shouldn't have to shoulder this responsibility on their own. Senior leaders can help by establishing short-term growth opportunities in entry-level roles—for example, by creating a career ladder. Staff who achieve specific accomplishments and demonstrate expertise in their role can move to the next ladder rung relatively quickly. 

2. Ensure newly hired millennials feel a sense of belonging and support

It's hard to overstate the importance of the first few months in a newly hired millennial's tenure, Vonderhaar says.  While many organizations focus on ramping up employees' clinical and technical skills, they often don't provide enough emotional and social support to new hires.

"Feedback from millennials with less than three years' tenure suggests their workplaces aren't always welcoming to new hires," Vonderhaar says. "Staff who don't feel a connection with their peers or their manager are likely to leave."

Illinois-based UnityPoint Health-Methodist | Proctor tackles this challenge head-on. To foster intra-departmental relationships, the two-campus hospital introduced a mentorship program to help newly hired nurses and allied health professionals adjust to their roles. "Many managers ask experienced staff to serve as informal buddies to new hires," Vonderhaar says, "but Methodist | Proctor has a much more formal way of providing new hires with support." Each unit has one to three mentors who each work with a group of approximately eight new hires, allowing mentors to actively help new hires connect with their peers.

The mentors and mentees receive paid time to attend meetings, and the program lasts for the first two years of new hires' tenure—much longer than typical buddy programs. And since the program is unit-based, Methodist | Proctor has fewer mentors than would be required for a one-on-one mentoring program. That means they're able to select mentors who have a passion for helping new hires learn the ropes.

3. Spot those looking for the door

Another key is to identify early-tenure millennials who are thinking of leaving the organization. Arriving late consistently, complaining more, suddenly taking more time off, updating a LinkedIn account—all of these are red flags that should lead you to increase your efforts to engage an employee, Vonderhaar says.

Vonderhaar recommends teaching managers to look for signs of trouble, especially during one-on-one meetings. Managers should check in with new hires after their first 30, 60, and 90 days to discuss and gauge job satisfaction, including the quality of their relationships with colleagues and whether the job has met their expectations.

Of course, some employees will decide to leave. When that happens, HR staff should schedule a meeting with the departing staff member to discuss their reasons for leaving and determine what might encourage them to stay, Vonderhaar says. Even if the employee ultimately leaves anyway, the information he or she shares can inform your employee retention and engagement strategies—and serve as a basis for reaching out to your ex-employee again later on.

"Maybe you finally completed that merger," Vonderhaar says. "Maybe you finally implemented that EHR system that was driving people so crazy. That's a great natural time to reach out to your former workers."

Learn more: Best practices to retain millennial staff

Join our experts on Monday, Dec. 4 at 1 pm ET to understand the factors behind early turnover and learn best practices to retain millennial staff through their first three years on the job.

Register for the Webconference

Have a Question?


Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.